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What is Pacemaker Implantation?

A pacemaker continuously monitors the heart’s rhythm and sends electric impulses to the heart’s muscle to make the heart contract when it is pulsing irregularly or too slow. The pacemaker itself consists of pacing leads and a pulse generator. The generator of the pacemaker is a small metal case that is no larger than a silver dollar, with a small computer and battery inside. The pacing leads are thin wires that carry electricity from the pulse generator to the heart. The pulse generator and the pacing leads work together to increase the heart rate, delivering appropriately oxygenated blood to the body. A pacemaker is placed in the feline by a licensed veterinary cardiologist and veterinary surgeon. 

Pacemaker Implantation Procedure in Cats

The veterinary cardiologist will evaluate the patient for proper pacemaker implantation. Ideal feline patients will have minimal structural heart disease, free of intracardiac tumors and other life-threatening health conditions. The feline patient will have a complete pre-implant evaluation including an abdominal ultrasound, tick serology, blood pressure evaluation, a 6-lead EKG (electrocardiogram), abdominal and thoracic radiographs, a urinalysis, as well as blood work. 

A pacemaker implant can be placed in one of two ways; transvenous pacemaker implantations or epicardial pacemaker implantations. Transvenous pacemaker implantations are reserved for dogs as their veins support the pacemaker lead running down their jugular vein and attaching the generator to the neck muscle. Cats on the other hand require epicardial pacemaker implantations, which allows the generator to be placed within the abdomen rather than the neck. 

The veterinary cardiologist and the veterinary surgeon work together to perform an epicardial pacemaker implantation in the pre-approved feline. A step-by-step procedure is listed below: 

  • The feline will be anesthetized with a pre-anesthetic combined with a pre-antibiotic to prevent infection and a pain medication. 
  • The feline will have an esophageal tube placed and supplementary oxygen will be given. 
  • Vital signs will be checked and gas anesthetic will be administered. 
  • An incision will be made though the cat’s diaphragm to place the generator. The use of an ultrasonic device will likely be used to assist for proper placement. 
  • The lead to the generator is attached to the apex of the heart and the lead is then run through a large vein where it meets the right side of the heart. 
  • The tip of the lead is then situated in the right ventricular apex, where it will connect to the inside of the heart’s muscle. 
  • The pacemaker will then be activated to deliver pulses of electricity down the lead to the heart where it will stimulate a contraction. 
  • The incision site will then be stitched closed and the feline patient will be sent to the recovery area. 

Patients will remain in veterinary care overnight to ensure the pacemaker is working properly. The procedure of implanting the pacemaker itself should take approximately 1-2 hours to complete. 

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Efficacy of Pacemaker Implantation in Cats

The prognosis for patients that have had a successful pacemaker implantation is generally good. The majority of patients live several years with their pacemakers with no adverse side effects. 

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Pacemaker Implantation Recovery in Cats

After the procedure, abdominal and chest radiographs will be taken to ensure proper placement of the pacemaker. The patient will be hospitalized overnight for continuous heart rate monitoring, which will ensure the pacemaker is functioning properly. The patient will be allowed to return home wearing a bandage over the incision for the next 7-10 days. Activity restrictions will be put into effect for 4-6 weeks after surgery and medications are to be administered as directed. 

Periodic follow-up examinations are to be expected, which usually coincide with interrogation of the pacemaker generator. The patient will not need to be anesthetized for interrogation as the pacemaker can be reached through an external magnet and computer. Interrogation of the pacemaker usually takes place every six months. 

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Cost of Pacemaker Implantation in Cats

The estimated cost of pacemaker implantation in cats is roughly $3,000 to $3,500. The total cost includes the exam, echocardiogram, radiographs, procedure, pacemaker device and the overnight costs of placing the pacemaker in the feline. 

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Cat Pacemaker Implantation Considerations

Now that your cat has a pacemaker implant, you will need to inform the veterinarian of this implanted device at every veterinary visit. Computed tomography (CT) scans and magnetic resonance imagining (MRI) can interfere with the functionality of the pacemaker, so ensure your veterinarian is aware of your cat’s device. Venipuncture of the vein that holds the pacemaker lead should be avoided as this action of drawing blood can damage the lead.  

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Pacemaker Implantation Prevention in Cats

Many felines that require pacemakers are of old age and it is the act of aging that has lead them to need a pacemaker. Other feline heart abnormalities might be able to be prevented with proper diet and exercise, but some felines have a genetic tendency to develop heart arrhythmias. 

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Pacemaker Implantation Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Gizmo

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short hair

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15 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Occasional Collapsing Of Back Legs

My cat is a candidate for this procedure however the hospital says they have only done about 8 of these surgeries in the past 4 years, with mixed (but mostly good) outcomes. Clearly 8 is not a great sample case study. I'm wondering which doctors have the most experience performing this procedure. Thank you.

July 5, 2018

Gizmo's Owner


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Dr. Michele K. DVM

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0 Recommendations

It is difficult for me to answer this question for you, as I do not know where you are located. You can always ask for a referral to another facility that offers that surgery for a second opinion, but that is a highly specialized procedure, and it may be difficult to find another surgeon able to provide that service for Gizmo.

July 6, 2018

Excellent point....I am in NYC but willing to travel for the right doctor.

July 7, 2018

Gizmo's Owner

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Julian

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tabby

dog-age-icon

7 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Rapid Breathing
Rapid Breathing, Lethargy

My cat has hypertrophic cardiomyopathy-can a pacemaker help this condition? His atrium wall is very thick. He is on oral lasix and other medications and has had to have lasix injections twice over the last 2-3 days at the vet.

April 13, 2018

Julian's Owner

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Dr. Michele K. DVM

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0 Recommendations

A pacemaker will not help with HCM, unfortunately. He'll need to be on lifelong medications to manage his heart disease and improve the function of his heart - there are other medications that can help him besides Lasix, if that is all that he is on, and that would be worth discussing with your veterinarian, as I do not know details about his condition.

April 13, 2018

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Tal

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domestic short hair

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11 Years

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Serious severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Lethargy

My cat has been diagnosed with 2nd degree AV block- Type two. I live in Calgary Canada and the vets are requesting I do an abdominal ultrasound to see if the cause is there. But this heart problem cannot be fixed (expect by pacemaker), then would the abdominal ultrasound be logical? And how log would she have before maybe this turns to a grade 3 or she worsens. I'm really confused and don't know ow to proceed.

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Piper

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short hair

dog-age-icon

5 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Critical severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Critical severity

Has Symptoms

Fainting
Occasional Collapsing Of Back Legs

My cat Piper received a Pacemaker implant just about 6 months ago and so far, so good. She returned to her normal self in seemingly no time and her quality of life seems great, if not better than before. I of course am very anxious over any little weird thing she does but I have to remember, she is a cat after all, they do weird things! The longevity of how well this pacemaker will operate is relatively unknown but I hope it gives her good quality of life for many years. They say the battery is good for 10, so that would be ideal. One day she seemed fine and the next, her heart was stopping for upwards of 7 seconds and she was dying. We are fortunate to live in NYC and have access to amazing facilities such as Blue Pearl and the Animal Medical Center who were both able to diagnose and the latter perform emergency surgery within hours. The Animal Medical Center has an excellent team of Cardiologists who were kind, empathetic, and generous. The cost is much higher than the above quote. We spent about $7,000 when all was said and done... not cheap, but so very worth it.

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Moe

dog-breed-icon

tabby

dog-age-icon

11 Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Fair severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Fair severity

Has Symptoms

Pass Out

My cat had a pacemaker implantation 3 years ago at the age of 9 and he is doing great! This procedure saved his life and was done by surgeons at the MSPCA Angell animal hospital in Boston. It was quite expensive and more than you read it should cost($3,000-$3,500). It cost us a little more than $6,000. Since it was an emergency we did not have the luxury of pricing such a procedure. You do have to have it interrogated every year.

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